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Appendix III. Procedures prior to entering and after exiting a cave or mine

By J. Judson Wynne

This approach discusses preparations for daily decontamination activities, including procedures prior to and after exiting a study site.

Prior to entering a cave or mineMultiday or single visits to a study site: (1) Upon arrival at a study site, stage non-caving gear (e.g., backpacks, hats, and trekking poles) in the clean zone. (2) Put on caving clothes and knee/elbow pads, then clean coveralls. (3) If coveralls lack elastic wrist cuffs, use duct tape to secure wrist cuffs to prevent the coverall arms from sliding up and exposing skin or underclothing.[1] (4) Put on boots. (5) Tape pant legs of coveralls to each boot/gaiter.[2] (6) For additional protection against a disposable coverall breach, place duct tape on elbows and knees (and seat, if necessary). (7) Stage clean clothing and hiking boots in the intermediate zone and place disinfecting equipment in the decontamination zone.

Return to same study site for multiple days at a cave/mine: (1) Stage non-caving equipment in the clean zone. (2) Proceed to the decontamination zone to obtain cave clothing, knee/elbow pads, boots, and related gear.[3] (3) Carefully remove clean clothing and place it in a clean, resealable ziplock bag. (4) Remove cave clothing from the sealed ziplock bag. (5) Follow steps 2 through 7 above (“Multiday or single visits to a study site”).

Procedures after exiting a cave or mine
(1) After exiting the study site, proceed directly to the decontamination zone. (2) Put on nitrile gloves. (3) Isolate field forms and notes.[4] (4) Brush off boots with nylon brush and disinfect coveralls and boots using isopropyl alcohol (70%) wipes. (5) Remove all necessary equipment from caving bag and place caving bag in the personal isolation bag (i.e., a garbage bag).[5] (6) Disinfect all personal equipment (e.g., helmet, water bottles, urine bottles, dry bags containing vertical gear and the exterior of ziplock bags used for equipment and isolating field forms) and group gear (e.g., metal clipboards, cave survey equipment, and electronics) using the most appropriate decontamination procedures (e.g., the three-step procedure for all equipment except vertical gear[6]). Disinfect vertical gear in accordance with the most recent WNS Decontamination Protocol (e.g., USFWS 2016). (7) Clean gloved hands.6 (8) Move disinfected equipment to the intermediate zone and retrieve clean clothing and hiking boots. (9) Return to the decontamination zone and use trauma shears to cut the duct tape wrapped around wrist cuffs and PVC boots/gaiters. (10) Remove PVC boots/hiking boots and then coveralls by turning the suit inside out. (11) Step into the inside of the coveralls. If there are no ruptures, the inside of your coveralls should not be “contaminated.” Therefore, you can safely stand on them, keeping your socks clean, until they are isolated in the subsequent steps. (12) Place PVC boots/hiking boots and knee/elbow pads in the personal isolation bag along with the previously isolated caving bag. (13) Remove clothing worn under the coveralls, place in a resealable ziplock bag, and deposit in the personal isolation bag. (14) Clean gloved hands and personal isolation bag.6 (15) Wipe down the inside of the bag up to where it is tied or zip-tied.[7] (16) Wipe personal isolation bag with isopropyl alcohol wipes followed by all-natural/biodegradable wipes. (17) Using all-natural/biodegradable wipes, clean exposed areas of skin (e.g., face, neck, and arms) and areas exposed to isopropyl alcohol during decontamination procedures.7 (18) Change into clean clothes. (19) Step out of coveralls when changing into clean boots. (20) With gloved hands, carefully place used coveralls into the appropriate isolation bag (e.g., personal or group) for either laundering/decontamination or disposal. (21) Remove nitrile gloves using standard medical glove removal procedures.[8] (22) Place used nitrile gloves into the appropriate isolation bag. (23) Clean hands. (24) Tie or zip-tie the group and personal isolation bags.[9] (25) Retrieve disinfected equipment from the intermediate zone and proceed to the clean zone.

[1]In some cases it may be possible to tape down glove cuffs to the coverall cuffs. However, from our experience, it is necessary to remove gloves to use survey and electronic equipment. Additionally, when working several hours at a given study site, this may also be impractical for toileting.

[2]Before taping, be sure to slide pant leg cuff up boot approximately 5 cm (2 in) to permit knee-bending mobility. If using hiking boots and gaiters, tape the top of the gaiter to the coveralls and the bottom of the gaiter to the boot.

[3]All equipment will have been staged at the study site on the previous day. Change from clean clothing into cave clothing and coveralls in the decontamination zone.

[4]Access to data collected daily is important, so that it can be evaluated and logged each evening. Place each page in its own resealable ziplock bag. Do not place multiple pages in one bag, because it cannot be opened at camp without risk of contamination.

[5]If operations at the study site are complete, dump contents of the caving bag onto the ground and place the caving bag in a garbage bag. If returning to the study site the next day, remove equipment from the caving bag that needs to be maintained for the next day (e.g., water bottles for replenishing, batteries for recharging, urine bottles for cleaning). In either case, follow the most recent WNS Decontamination Protocol (e.g., USFWS 2012).

[6]Decontaminate using isopropyl alcohol (70%) wipes. For water bottles, rinse the exterior with clean water prior to reuse.

[7]If logistics permit, biodegradable soap and water should be used to wash hands and body. P. Ormsbee (2011, personal communication) used this approach in Washington State. By vigorously washing hands and exposed parts of the body with soap and water, you can potentially remove P. destructans hyphae and spores/conidia mechanically. If this is not possible, use antibacterial hand sanitizer and antibacterial wipes in an attempt to mechanically remove the hyphae and conidia from skin.

[8]Pinch glove of one hand carefully on the inside of the wrist and remove it by turning it inside out, then remove the other glove using the clean interior of the glove previously removed.

[9]The last person to complete the procedures after exiting a cave or mine is responsible for closing the group isolation bag. Follow same procedures as for closing personal isolation bags.